Did you know that by age 65, more than one-third of women in the United States have had a hysterectomy? Also, women living in the South or Midwest are more likely to have a hysterectomy.
Hysterectomy is a descriptive term that covers a range of surgical procedures and options. At its most basic, a hysterectomy is surgery to remove a woman’s uterus.
Different types of hysterectomies involve removal of more or fewer organs.
» Partial hysterectomy involves removing only the upper part of the uterus (not including the cervix). This is also called a subtotal or supracervical hysterectomy.
» Total hysterectomy includes removal of the uterus and cervix.
» Radical hysterectomy is normally recommended when cancer is suspected. Surgery removes the uterus, cervix, fallopian tubes, portions of the vagina and any lymph glands that might be affected. In some cases, surgery also removes the ovaries.
Many gynecological surgeries, including hysterectomy, can be performed with traditional open surgery, involving larger incisions, or minimally invasive surgery with several small incisions. Robotic-assisted gynecological surgery is another, newer minimally invasive option for women to consider.
Hysterectomies for benign and malignant conditions are two of the most common robotic-assisted gynecological surgeries.
This procedure is becoming more widely used for benign diseases of the uterus, including fibroids, abnormal bleeding and adenomyosis, a condition in which the inner lining of the uterus (endometrium) grows into the uterine wall.
Robotic-assisted hysterectomy can also be used as part of larger procedures for the treatment and staging of endometrial cancer and early-stage ovarian cancer.
Robotic hysterectomy uses three or four small incisions to remove the uterus through the vagina. The gynecologist works at a separate console, viewing the internal organs through a 3-D, magnifying monitor and operating with remote hand controls. Recovery is an overnight stay in the hospital with rapid return to work, often within two to three weeks.
Benefits of robotic-assisted hysterectomies include:
» The robotic instruments are designed to reach the exact angle to stop a blood vessel’s bleeding.
» All of the robot’s movements are very smooth and precise, minimizing damage to surrounding tissue and organs.
» Overall, there’s less blood loss and damage to surrounding tissue as well as a lower risk of infection compared to open procedures.
In addition, patients experience less pain, and some go home the next day. Other patients usually go home from the hospital after one to three days. Full recovery can take up to six weeks, but most women feel dramatically better and resume normal activities within two weeks.
Keep in mind that gynecologists always try to use other treatments until a woman no longer wants children. Younger women suffering from fibroids, abnormal bleeding, endometriosis, pelvic inflammatory disease or pelvic organ prolapse might also face a hysterectomy if other treatments are unsuccessful. Gynecological cancer represents a major health danger and will likely require hysterectomy.
Relatively recently, gynecologists often will remove the fallopian tubes to reduce, but not eliminate, the risks of ovarian cancer. Some cases of ovarian cancer actually come from the fallopian tubes.
If the cervix is removed, the risks of cervical cancer are almost eliminated. Total hysterectomy also eliminates the risks of uterine cancer. Removal of the ovaries and fallopian tubes during a hysterectomy dramatically reduces, but does not completely eliminate, the risks of ovarian cancer.
A hysterectomy is a major surgery that can have complications such as bleeding or infection. Most patients have significant and long-term improvements in their health post-hysterectomy and rarely regret having the procedure if medically indicated. This decision should be made in consultation with a gynecologist to understand the surgical options, alternatives and benefits.
Each woman’s choice depends on her medical history, other health conditions and reasons for the surgery.
Dr. Jenna MacLennan received her medical degree from the Medical University of South Carolina in Charleston. She also completed an Obstetrics and Gynecology residency at the Medical University of South Carolina. She cares for patients at McLeod OB/GYN Associates, located at 101 William H. Johnson Street, Suite 500, Florence, SC. To schedule an appointment, call 843-777-7400.